Adolescence is a developmental stage, which includes many changes. Relationships with parents can support the adaptation to these changes or contribute to a crisis period, in which psychological disorders, such as depression or selfdestructive behaviours, may occur.

The objective was to identify the types of parental attitudes and their correlation with the occurrence selfdestructive behaviours in their children.

The goal is to examine the relationship between parental attitudes and the tendency toward self-destructive behavior among youngsters with depression.

This is a comparative study between a sample of youngsters, ranking from 15 to 19 years, diagnosed with depression and presented self-destructive behaviours, and a normative sample comprising of youngsters who have no such history, attending secondary school. All participants in the survey completed the experimental version of the Self-Injury Self- Report Inventory (Kammie R. Juzwin, 2004) which identifies types of self-destructive behaviours (direct and indirect), and the Parental Attitude Scale (M. Plopa, 2005), which identifies five types of parental attitudes.

Parents of teenagers diagnosed with depression manifest an inconsistent (p=0,003), emotionally rejecting or overdemanding (p=0,011) attitude towards their adolescent children more often than parents of children in the control group. There is a link between the inconsistent and rejecting attitude of the mother and the occurrence of direct self-destructive behaviors (r= 0,356; p< 0,05).

Parental attitudes towards the teenagers in the control group are more positive (autonomy, acceptance) than those displayed by the parents of adolescents with depression.

Conventional treatment programs of anorexia nervosa are successful in the restoration of body weight; however, recidivism is common and the rate of relapse is high. For twenty years, The Child and Adolescent Psychiatric Department of the University of Nice used to offer a standard treatment based on psychotherapy for both in/out-patients suffering from anorexia nervosa.

Progressively, we have developed an innovative pattern of care based on the psychopathologic hypothesis of troubles in early integration of perceptive functions. This way of caring constitute a form of therapy to fight anorectic symptoms by the re-appropriation of feelings and the affective reminders linked to them.

We have created 4 therapeutic workshops. Three of them use sensorial stimuli: olfactory, tactile-kinesthetic and auditory. The fourth one is a discussion group. We propose all adolescents to try these workshops in addition to the normal care program.

We note two principal effects of this innovative way of caring: the reduction of the number and the duration of hospitalizations and the improvement of therapeutic alliance.

The scientific assessment of the impact of this sensory way of caring on the BMI, on the therapeutic alliance and on the hedonic faculties over 2 years is being. And the results should objectify our clinical findings.The use of sensory pathways and their relationship to memory traces and emotions helps the lifting of denial, the sagging of cleavages and reduces pain following the necessary weight regain in the institutional treatment of adolescent anorexia nervosa.

This study aimed to evaluate the interference of tobacco smoke on immunochromatography assay for urinary benzodiazepines detection and the interest of two biological markers and smoking status parameters as predictive factors of false results.

Our study included 256 voluntary subjects (143 passive smokers and 113 smokers). Cotinine was measured by homogenous immunoenzymatic assay and SCN- by selective electrode. Urinary drugs were detected by immunochromatographic assay. A positive result is completed by an analytical method with an immunometric assay.

False positive results for benzodiazepines are significantly more frequent in smokers compared with passive smokers (90.2% Vs 22.4%, p< 10-3). For smokers, the number of cigarettes was significantly higher in subjects with falsely positive results for benzodiazepines compared with subjects with negative results (32 ± 11 Vs 20 ± 10; p= 0.04). Between these two groups, we established a significant difference for urinary cotinine (345 ± 211 Vs 117 ± 54 μg/μmol; p< 10-3) and for plasma SCN- (101.6 ± 3.4 Vs 98.8 ± 2.1μmol/L; p=10-3). Urinary cotinine and consumption duration present the highest values of AUC of the ROC curves. The cut-off of 167.6μg/μmol and 10.5 years were found as predictive factors of false positive Results.

Tobacco smoke interferes with immunochromatographic assay of urinary drug detection; therefore, all subjects must be questioned about their smoking status to avoid such false results during results interpretation.

Few studies have reported the complexity of the tasks performed by professionals of the Family Health Strategy in Brazil.

Describe the sociodemographics, work conditions, minor psychiatric disorders (MPD) and CAGE positivity of physicians, nurses and dentists employed by the FHS in Feira de Santana (Bahia, Brazil).

Cross-sectional, epidemiological study using standard questionnaires (SRQ-20 and CAGE) to collect anonymous information on the sociodemographics profile, work conditions, mental health and alcohol consumption of physicians, nurses and dentists working for the FHS. The data were analyzed with SPSS software.

The overall prevalence of MPD was 16.0% (physicians=17.4%, nurses=15.5%, dentists=15.2%). The prevalence of alcoholism was 5.0% among physicians and 7.7% among dentists. The features “female gender”, “young adult”, “married”, “affiliated with a cooperative”, “long work week” and “more than one job” predominated in the sample.

The prevalence of MPD and CAGE positivity was smaller in our sample than in other, similar studies.

Currently, studies taking into account the incidence of burnout in Nurses Rehabilitation Specialists (NRS) are scarce, a fact which reinforces the need for further investigations in order to be able to understand the real impact of this syndrome in this professional category. This study aimed to determine the occurrence of burnout in NSR and determine whether there is any relationship between the different domains of burnout and sociodemographic aspects, and psychosocial work.

We conducted a cross-sectional, quantitative and analytical, which was attended by 117 NSR carrying out functions in various health institutions Portuguese's, aged between 27 and 57 years. To measure the variables used the following instruments: Scale MBI-GS, General Labor Satisfaction Scale, Scale My Health Locus of Control Scale and Levenson's Global Self-Esteem Scale for adults.

With regard to levels of burnout in NSR conclude that men have higher rates in the dimensions “physical and emotional exhaustion” and “cynicism” compared to women with an average ranking of 11,89 vs 11,57 and 9,56 vs 9,48, respectively; the dimension “professional effectiveness” are women who are more prone to burnout, with an average ranking of 31,20 vs 30,11. The data reveal that there are significant influences of variable working “time professional in the art.” Are obtained also for any significant influences of the psychosocial variables: locus control and self-esteem.

The evidence found in this study invite us to prepare and reflect on new strategies of intervention training and information aimed at promoting labor welfare of these subjects.

Mania has been estimated to represent the cause of 4.6% to 18.5% of all geriatric psychiatric admissions and 10% of new-onset mania cases have been found to occur in individuals over the age of 50. Age of onset can have a significant impact on the nature and course of bipolar illness.

Review the current literature of pharmacologic management of late-life bipolar disorder and discuss the differential diagnosis.

Brief literature review.

Case report and literature review.

We describe a case of a 76-years-old female with elevated mood, verbosity, distractibility, irritability, inadequate social behavior, reduced requirement of sleep, increased physical activity, impulsive business investments. Several tests were made: analytical study, CT scan and neuropsychological evaluation, none with significant alterations. She was treated with an antipsychotic drug with improvement of symptoms.

There is a limited evidence base for treatment of bipolar disorder in the elderly and further controlled studies are needed. Current data suggest that valproate and lamotrigine may be better tolerated as mood stabilizers than lithium. Preliminary reports suggest a role for the use of atypical antipsychotic in older adults with bipolar disorder although potential benefit must be balanced against the potential risks of treatment. In treating elderly bipolar patients, one has to keep in mind that pharmacokinetic and pharmacodynamic changes that occur with ageing, associated with frequent concomitant medical illnesses and their treatments, are likely to increase the risk of adverse events and drug interactions.

To review the historical evolution of the Fatigue Impact Scale (FIS), presenting its main features and modified versions.

Two independent reviewers performed a search in PubMed for articles, available since the development of the scale until June 2012, looking for those studies that used the FIS or any of its modified versions as an instrument for data collection. The terms used for the search were “Fatigue Impact Scale.” After individual analysis and consensus procedure, 201 articles were selected for the data basis of this study. Data were extracted using standardized forms with the following information: version of the scale, year and country where the study was conducted, the methodological study's design, language in which the scale was applied, and how many patients responded to any one of the versions.

This review found 4 validated modified versions of FIS and 2 reduced forms, in 27 different countries. The largest concentration was in United States, followed by other English-speaking countries. The FIS was the version most commonly used, followed by the Modified Fatigue Impact Scale (MFIS). Approximately 46,483 individuals have been evaluated with one of the versions of FIS in 29 different pathologies. Most of these studies used a cross-sectional design.

The number of studies using the FIS and its modifications has grown substantially. However, this study evaluates methodological limitations which still hinder the synthesis of the scale's performance through meta-analysis. Still, the FIS has been used in relevant studies that contribute to understand fatigue broadly.

Depression - the main cause of suicidal behavior among young people.

Optimizing therapeutic approaches to the correction of non-psychotic depression accompanied by suicidal behavior in young adults.

75 patients with psychogenic depression, committed suicide attempt.

Clinical-psychopathological, psychodiagnostical.

The clinical picture of depression in the patients the most frequently observed in depressed mood and affect sadness, asthenic symptoms, as well as various manifestations of anxiety. The vast majority of patients were found various violations of sleep-wake cycle. Feature of depressive disorders was their massive somatization characterized by polymorphic vegetative disorders.

Building on the received data in the work we have developed pathogenetically grounded system of correction of depression involving suicidal behavior, which includes the application of integrated psychotherapeutic programs in conjunction with medical treatment. In conducting drug therapy should be given preference for the latest generation of antidepressants with a proven safety profile, high therapeutic index and low “behavioral toxicity”. Psychotherapeutic correction includes family therapy, cognitive-behavioral therapy, interpersonal psychotherapy, and psychoeducational training.

Developed and implemented in practice the system of psychotherapy and medical and social rehabilitation of patients with depression involving suicidal behavior, which confirmed the effectiveness of data of observation after 12 month.

Conducted follow-up study showed the high efficiency of the proposed system of psychotherapeutic interventions for example 83.8% of patients with repeated suicide attempts were observed, 16.2% had undergone repeated courses of complex therapeutic interventions due to additional stressful circumstances.

Homosexuality may be misunderstood by some psychiatrists if childhood history is not fully explored.

To determine the sexual orientation effects that may result due to childhood sexual abuse in Saudi males.

To explore whether childhood sexual abuse in Saudi males will change their adult sexual orientation and its psychodynamic understanding.

53 saudi males referred to psychotherapy clinic because of homosexuality were assessed using standard psychiatric clinical interview and followed up for psychodynamic psychotherapy for at least 2 years.

53 Saudi males aged (17–31) years were found to be abused sexually before the age of 10 years.39 (74%) were abused by relatives and others whereas14 (26%) were abused by non- relatives. 46(87%) had full sexual intercourse and for2–5 times but only 19(35.8%) the abuse continued for at least one year .On examination, none of them was found to be homosexual, but 36 (67.9%) were bisexual. As anal intercourse with wife is religiously forbidden, all married 27 (50.9%) had marital problems due to their sexual preference to anal intercourse.

In reserved and closed culture as in Saudi Araibia, sexual abuse of children especially males may be prevalent and especially by relatives. Childhood sexual abuse may affect sexual orientation in adulthood to be bisexual. This may be due to behavioral modification or impulsivity as a deep ingrained revenge by the victims as a redirection of aggression towards males or wives by anal intercourse.

Factitious disorder (FD) is defined by the intentional production or feigning of physical or psychological symptoms with the objective of assuming the patient role. It's frequently difficult to adequately diagnose this disorder when the faked symptoms are those of a psychological or a psychiatric disorder. In these cases, there is often high comorbidity with other mental disorders, thus making it difficult to differentiate between real and factitious symptoms.

To present a case-report of FD with hallucinations and a review study regarding the theme available in Medline.

Brief literature review.

A case report is presented and literature of this theme shortly reviewed.

The case involves a 23-year-old female, a psychology student, born in destructured family. She had attempted suicide many times since she was 16 years old, one of them with high lethality. One month before her admission to our inpatient clinic in order to allow a clear diagnosis to be made, she began active auditory hallucinations, persecutory delusional ideation with disorganized behavior and consequent social isolation. A suitable dose of atypical antipsychotic drug was administered but Psychotic disorder was ruled out and she was dignosed with FD. After the factitious symptoms that prevented any type of therapeutic approach disappeared, the real symptoms of the patient were those characteristic of a borderline personality disorder.

This case emphasizes the need for the careful observation of these patients in order to establish the diagnosis and to improve a specific management strategy for them.

The comorbidity of mental illness and substance abuse (dual diagnosis) can complicate both clinical picture and prognosis. It is therefore important to recognise both nosological entities and to treat them simultaneously.

Our main aim was to investigate and describe the characteristics of dual diagnosis patients who were in treatment with a community addiction service, and to assess the completeness of clinical documentation.

We created a data collection tool to measure indices of illicit substance and alcohol use, psychiatric diagnosis, and treatments received for both problems. We included measures of physical health relating to drug and alcohol use. Clinical information was collected from the electronic patient record system.

The audit is ongoing. 498 patients were under the care of the addictions service in February 2012. To date we have identified 72 patients (14.5%) with dual diagnosis. Of this group, 79% of patients were addicted to opiates and 42% were polysubstance users.

The psychiatric diagnosis included mood disorders (29%), anxiety disorders (24%) and psychosis (14%). However 28% had no formal diagnosis recorded, despite receiving treatment for psychiatric conditions.

67% were prescribed methadone. 40% of the patients were receiving medication for their mental illness.

14.5% of our addictions population had a mental health problem. We identified lapses in clinical documentation related to both illnesses. The distinction between addictions and psychiatric services can bring difficulties in communication and care provided. Quality and continuity of care is important and consideration should be given to further development of dual diagnosis services.

ECT has demonstrated to be an effective and safe biological treatment that can be considered as an alternative to pharmacotherapy, especially for treating severe, resistant and recurrent, affective, psychotic and catatonic symptoms. CECT refers to the one that is started after acute treatment and lasts for a maximum period of 6 months with the objective of preventing relapse. M-ECT is the one that is started once C-ECT has ended with the aim of preventing recurrences. The aim of this study was to explore the evidence for using C-ECT and M-ECT as an alternative to pharmacotherapy.

We performed a search in MEDLINE, PubMed and Cochrane, from 1950 until the present to identify articles in which C-ECT and M-ECT were used as alternative treatments to pharmacotherapy.

C-ECT and M-ECT have demonstrated to be an effective and safe alternative to pharmacotherapy in Unipolar Depression, Bipolar Disorder and Schizophrenia, especially in the prevention of relapse and recurrences. It reduces number and days of hospitalization. In combination with pharmacotherapy, it increases effectiveness of pharmacological treatment. It does not affect cognitive functioning.

C-ECT and M-ECT should be considered as an alternative to pharmacotherapy in the treatment of affective and psychotic, severe, resistant and recurrent symptoms. It is an effective and safe treatment, which prevents relapse and recurrences in severe mental illness, reducing hospitalization rates and health costs.

Religion and Spirituality have a close relationship with mental health throughout human history. However in the 21st century, post-modern world their roles has attracted attention and debate in the context of clinical practice.

The aim of the presentation is to reflect on the understanding of spirituality and religion in the post-modern world with their relevance to mental health and to explore the current opinions and views in their clinical application.

To present the two conflicting school of views in their clinical use.To identify training needs in psychiatric curriculum with respect to the above.

A comprehensive literature search on the subject of Spirituality and Religion in mental health was carried out. Different schools of opinions were identified and their positives and negatives was analysed. A questionnaire was compiled to highlight the important areas of conflicts in clinical practice (useful religious practices, boundaries, self-disclosure, etc) A survey was sent out online via the surveymonkey website. The results were collated and analysed for trends.

It is only intuitive to link mental health with Spirituality and Religion. However it is crucial to identify the spiritual and religious beliefs of the patient and use it effectively in their care plan.

Clinician to be aware of his own prejudices and how this might affect his practices.

It is important to separate from Religion and Spirituality, though overlapping, they are diverse and unique to every individual.

To differentiate clinical practice and research evidence. Clearer guidance and better training advocated for practice.

According to WHO data it is expected that by 2030 depression will become the most common disease of mankind. As of fairly recent a time, began the use of agomelatine as an antidepressant, a drug which operates through different mechanisms than the pharmaceuticals used before. However, the effects of agomelatine on the elderly patients is still not well researched. On the other hand, the demographics of Europe show that the percentage of elderly population will be increasing.

Within this clinical study, we examine the effect of a 25-50 mg per day dose admited to persons over 65 years of age. The examinees all suffer from depresive disorders the efect on which is the primary subject of this study, regardless of other physical and psychological comorbidities. Exclusion criteria for participation in the study include liver disease (elevated serum transaminases) and combination with CYP1A2 inhibitor drugs. The study included fifty patients who are monitored over a course of six weeks. The following measuring instruments are used in the study: HAM-D17, GDS-30, Beck D. Q, SHAPS scale, PSQIand the Elderly's Quality of Life Questionnaire. Each participant is tested twith the battery of questionaires listed above prior to admission into the study, and once again after six weeks of agomelatine teraphy.

The study is currently in progress, so there are no deffinitive results as of yet.

Is the agomelatine an efficient antidepressant treatment in elderly patients.

The prevalence of mental disorder and addiction in any prison population is higher than for the general public. Mental health in-reach and addiction services were developed to treat this complex population. We identified the need to evaluate the service provided in a local prison, and make suggestions for improvement.

Our main aim was to investigate the need for dual diagnosis services in a local male community prison.

Our data collection tool consisted of five parts;

1. 1) Demographic Data,

2. 2) Addiction problems and input received,

3. 3) Psychiatric diagnosis and input received,

4. 4) Physical health including medical problems related to substance use

5. 5) Other comments including risks identified.

The data were collected from the prison's patient record system.

From the 134 inmates that were under the care of the addictions service in January 2012, 26 had a dual diagnosis (19%). From the dual diagnosis population, 24 inmates (92%) were mainly addicted to opiates. The main substitute prescribed was methadone (n=14).

The most common psychiatric diagnoses was schizophrenia (35%) and anxiety disorders, with or without a personality disorder.

We found a big proportion of the addictions population with a psychiatric diagnosis (19%). As both illnesses can be interlinked and affecting prognosis it is important that we treat both simultaneously. The distinction between addictions and mental health services can bring difficulties in communication and care provided. A dual diagnosis service is therefore needed to assure quality and continuity of care in prison and to assist smooth transition after release.

Socially prescribed perfectionism has been associated with long-term sleep disturbances (Azevedo et al., 2010).

To investigate the association between perfectionism dimensions and insomnia in pregnancy.

581 pregnant women, mean age 29.8 years (SD=4.5), average weeks of gestation 32.6 (SD=3.5), mostly married (75%) and nulliparae (64%) participated in the study. The multidimensional perfectionism scale (Hewitt and Flett, 1991; Soares et al., 2003) was used to assess total levels of perfectionism, self-oriented perfectionism (SOP) and dimensions of socially prescribed perfectionism (SPP): others high expectations (OHE) and conditional acceptance (CA) (Macedo et al., 2009). Insomnia symptoms and related daytime impairment were assessed with an insomnia questionnaire (Marques et al., 2011). Objective estimations of sleep were obtained through actigraphy in a small group (n=60).

In comparison to good sleepers, insomniacs showed higher levels of SPP (M=53.4, SD=13.0 versus M=49.6, SD=12.3, p< .05) and SPP-CA (M=19.6, SD=6.1, versus M=18.0, SD=5.5, p< .05). Women with difficulties initiating sleep reported higher levels of SPP-CA than good sleepers. Analyses of actigraphy revealed that SPP-CA was associated with less sleep time (r=-.45, p< .05), less sleep efficiency (r= -.34, p< .05), more time awake during sleep (r= .43, p< .05) and more mean activity asleep (r= .38, p< .05).

Conditional acceptance is the SPP perfectionism sub-dimension particularly associated with self-reported insomnia and sleep alterations measured objectively with actigraphy in pregnancy.

Portuguese foundation for science and technology (POCI/SAU-ESP/57068/2004).

The relationship between sexuality and schizophrenia is complex. The prevalence of sexual dysfunctions is higher in persons with mental disorders and may be related to both the psychopathology and the pharmacotherapy. On one hand the negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships; on the other hand several mechanisms can cause sexual dysfunction during antipsychotic therapy. Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited. The aim of this study was to evaluate the sexual dysfunction and its impact in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions.

Subjects included were sexually active male and female patients 18 years of age or older with the diagnosis of Schizophrenia, Schizophreniform disorder, Schizoaffective disorder or other psychotic disorder. In addition to sexual functioning, was recorded demographic data, psychiatric diagnosis and medication history. The instrument of evaluation used was the Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex).

All the analyses were performed in the 101 evaluable patients. Most patients were males (76%) and the most common diagnosis was Schizophrenia.Overall, the patients exhibited sexual dysfunction according to the assessment with the SalSex. Among the patients exhibiting sexual dysfunction, a third reported to have poor tolerance to the disturbance.

Sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics and it is associated with a great impact in a substantial proportion of patients.

Item Response Theory (IRT) allows for dimensional scaling of the severity of a disorder, and comparison of symptoms’ properties across different measures of the same trait and across groups. IRT has never been applied to Posttraumatic Stress Disorder (PTSD).

To determine discrimination and severity parameters of PTSD symptoms measured with two instruments, and to examine gender- and age-related Differential Item Functioning (DIF) of PTSD indicators.

To inform the dimensional scaling of PTSD in youth.

IRT was applied to PTSD items measured with the DPS and the PTSD-RI in 6,733 9/11-exposed youths. DIF analysis was performed in the sample stratified by gender and age (8-13; 14-21).

DPS and PTSD-RI items are most informative at intermediate and severe levels of PTSD, respectively. Across instruments, discrimination was greatest for insomnia and nightmares, and lowest for 9/11-related thoughts. Severity parameters were highest for avoidance and numbing symptoms, and lowest for 9/11-related thoughts. The majority of PTSD symptoms showed significant DIF across subgroups.

DPS and PTSD-RI criteria are informative at different levels of PTSD severity. PTSD symptoms differentially discriminate among individuals along the PTSD continuum, and are most informative at different levels of PTSD severity. These results could inform dimensional scaling of PTSD, and allow for flexibility in assigning cut-off points for facilitating clinical decision-making. PTSD criteria do not provide the same information across subgroups defined by gender and age, suggesting that symptoms differ in the way they represent severe post-traumatic stress reactions across groups.

Agenesis of the corpus callosum is a congenital anomaly consisting of a failure in the development of the transverse fibers of white matter that connect the two cerebral hemispheres. It may be partial or complete and is often associated with learning disabilities and epilepsy. More recently, a link was established between agenesis of the corpus callosum and several neuropsychiatric disorders, including psychotic phenomena.

Case report and literature review using PUBMED.

The authors describe the case of a 43 year old patient with no previous psychiatric history that presented with behavioral problems and persecutory delusions. CT scan and MRI showed partial agenesis of the corpus callosum. Neuropsychological investigation revealed mild mental retardation. EEG was normal. The literature review allowed the authors to conclude that, although there are only a few cases reported, there is an established connection between agenesis of the corpus callosum and the onset of psychotic symptoms. This connection can be explained by the fact that corpus callosum is an important structure not only in allowing communication but also in regulating the activity established between the two hemispheres. In this case, a regulation loss could predispose to psychosis.